Professor Ralph Blacket (1919-2008) - Obituary

Doctor made breakthrough on heart disease

January 26, 2009
Ralph Blacket, 1919-2008

RALPH BLACKET, the foundation professor of medicine at the University of NSW, was one of Australia's leading researchers into heart disease.

Convinced of the importance of lipids, particularly cholesterol, in the growing epidemic of heart attack and coronary artery disease, Blacket established a lipid chemistry laboratory and built a team of biochemists, clinicians, dietitians and food technologists. In 1966 the group carried out the Diet Heart Study, which demonstrated that substituting polyunsaturated vegetable fats for saturated animal fats would significantly reduce the incidence of heart disease.

Ralph Beattie Blacket AO, who has died at 89, was born in Mosman and grew up in Hurstville where his father, Selwyn, started a real estate agency. The Blackets were indirectly descended from Edmund Blacket, the colonial architect. Ralph's father and mother, Prudence (nee Beattie) both died when he was a young man.

As a boy he watched a young Don Bradman, and later Bill O'Reilly, play cricket for St George. He played the game with distinction at Sydney Boys High School, where he was dux in 1935. He later captained the St George third-grade team, which included the future Test players Ray Lindwall and Arthur Morris. At the University of Sydney, where he studied medicine, Blacket played first grade, gaining a blue.

He graduated with first-class honours in 1941 and enlisted almost immediately in the Australian Army Medical Corps, from which he was seconded to the AIF 31 Infantry Training Battalion. Posted to Milne Bay, he served in New Guinea and Borneo for the rest of World War II.

Afterwards, Blacket did a year's residency at Royal Prince Alfred Hospital, worked with the Red Cross, and went to St Mary's Hospital in London, then under the brilliant if irascible leadership of Sir George Pickering. There he had his first taste of high-quality research with a team drawn from around the world. He also visited leading research centres in the United States.

Back at RPAH in 1950, he became the first Hallstrom Fellow in Cardiology and, with Jean Palmer, established Australia's first cardiac catheter laboratory. In 1952 he was made an honorary assistant physician at RPAH and lecturer in medicine at Sydney University. He established a busy private cardiology practice and Australia's first pulmonary function laboratory, which became a nursery for young researchers.

Remembering prisoners of war, Blacket worked on the heart disease beriberi, the result of thiamine (vitamin B1) deficiency. He provided the world's first comprehensive understanding of how this deficiency led to the malfunction of almost every organ system in the body. His doctoral thesis in 1956 was awarded the Bancroft prize for research and remains the seminal work on the disease. By 1958 he was senior physician in cardiology at RPAH.

In 1959 he became foundation professor of medicine at the medical school of the University of NSW, and director of medicine at the faculty's clinical teaching centre, the Prince Henry Hospital. The teaching school at Prince Henry and, soon after, Prince of Wales was founded on the principle of seamless continuity between academic teaching, research and delivery of clinical care. The principle holds that teaching is best carried out by doctors involved in research and that medical practice is better served by asking informed questions than in knowing a textbook full of answers. Such principles were regarded as radical at the time by a specialist medical community accustomed to the primacy of the honorary consultant practising medicine remote from research and laboratories.

Findings of the Diet Heart Study were published in two papers in The Lancet in 1974. Meanwhile, Blacket had built a strong multidisciplinary medical unit, engaging leading specialists in neurology, cardiology, respiratory medicine, renal medicine, gastroenterology, infectious diseases and endocrinology.

Right to his retirement in 1983, he was active in clinical care, research and teaching. He stood firm for academic standards when political and financial considerations were threats on the horizon. His output as a scientific contributor was prodigious.

He wrote letters, including to the Archbishop of Canterbury, Margaret Thatcher, John Howard and the Herald. One to this paper in 1991 said: "I spent four years of my early life fighting the Japanese. Bullets are lethal. There is no place for them in a peaceful, democratic society. I cannot understand why politicians don't ban guns."

His sense of humour was dry, with a chuckle. He entertained colleagues and visitors at home. He had married Margaret McIlrath, a nurse, in 1945 and they had five children whose memories of his dominant and opinionated personality remain strong. Margaret was tolerant, an excellent cook and inspired gardener, who created the serene ambience Ralph needed when he eventually got home at night. He was a good pianist, with a love for Beethoven and Chopin in particular.

Graham Macdonald and Tony Stephens1

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